Skip to main content
 

Main menu

  • Home
  • Content
    • Current Issue
    • 2018 Open Forum Abstracts
    • Editor's Commentary
    • Coming Next Month
    • Archives
    • Top 10 Papers in 2018
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • Call for Abstracts 2019
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
American Association for Respiratory Care
  • Subscribe
  • My alerts
  • Log in
American Association for Respiratory Care

Advanced Search

  • Home
  • Content
    • Current Issue
    • 2018 Open Forum Abstracts
    • Editor's Commentary
    • Coming Next Month
    • Archives
    • Top 10 Papers in 2018
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • Call for Abstracts 2019
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Follow aarc on Twitter
  • Visit aarc on Facebook
Review ArticleNarrative Reviews

Pulmonary Thromboses in Pediatric Acute Respiratory Distress Syndrome

Magalie Caudron, Tanya Holt, Geoff DE Cuvelier, Jeffrey Dmytrowich and Gregory Hansen
Respiratory Care February 2019, 64 (2) 209-216; DOI: https://doi.org/10.4187/respcare.06106
Magalie Caudron
Division of Pediatric Critical Care, University of British Columbia, Vancouver, British Columbia, Canada.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tanya Holt
Division of Pediatric Critical Care, Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Geoff DE Cuvelier
Pediatric Hematology-Oncology-BMT, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jeffrey Dmytrowich
Division of Pediatric Critical Care, Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gregory Hansen
Division of Pediatric Critical Care, Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: gregory.hansen@usask.ca
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Pediatric ARDS continues to be a management challenge in the ICU with prolonged hospitalizations and high mortality. Thromboembolic pulmonary embolism and in situ pulmonary artery thrombosis might represent underappreciated thrombotic processes for a subset of these patients. Although well described in the adult literature, descriptions of pulmonary thromboses with pediatric ARDS are limited to case reports. However, many risk factors for pulmonary thromboses are present in children with ARDS (eg, coagulopathy, endothelial injury, central venous catheters, concomitant inflammatory diseases), suggesting a much higher incidence is plausible. Based on an interpretation of animal, pediatric, and adult data, we propose a diagnostic algorithm to facilitate a timely and accurate diagnosis. Observing an alveolar dead space fraction ≥ 0.25, or either a 50% increase in physiologic dead space/tidal volume or a central venous saturation ≤ 60% over 24 h, triggers the algorithm. Together with targeted heparin treatment and right ventricular afterload reduction, clinical outcomes might improve if this particular patient subgroup can be identified early. While anticoagulation is recommended in adults with confirmed pulmonary embolism and low early mortality risk, data for children are limited.

  • acute respiratory distress syndrome
  • pediatrics
  • pulmonary embolism
  • thrombosis

Footnotes

  • Correspondence: Gregory Hansen, Pediatric Intensive Care Unit, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8. E-mail: gregory.hansen{at}usask.ca.
  • The authors have disclosed no conflicts of interest.

  • Copyright © 2019 by Daedalus Enterprises
View Full Text

Pay Per Article - You may access this article (from the computer you are currently using) for 1 day for US$15.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

Log in using your username and password

Forgot your user name or password?
PreviousNext
Back to top

In this issue

Respiratory Care: 64 (2)
Respiratory Care
Vol. 64, Issue 2
1 Feb 2019
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Association for Respiratory Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Pulmonary Thromboses in Pediatric Acute Respiratory Distress Syndrome
(Your Name) has sent you a message from American Association for Respiratory Care
(Your Name) thought you would like to see the American Association for Respiratory Care web site.
Citation Tools
Pulmonary Thromboses in Pediatric Acute Respiratory Distress Syndrome
Magalie Caudron, Tanya Holt, Geoff DE Cuvelier, Jeffrey Dmytrowich, Gregory Hansen
Respiratory Care Feb 2019, 64 (2) 209-216; DOI: 10.4187/respcare.06106

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Pulmonary Thromboses in Pediatric Acute Respiratory Distress Syndrome
Magalie Caudron, Tanya Holt, Geoff DE Cuvelier, Jeffrey Dmytrowich, Gregory Hansen
Respiratory Care Feb 2019, 64 (2) 209-216; DOI: 10.4187/respcare.06106
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Introduction
    • Epidemiology of Pediatric ARDS and Pulmonary Emboli
    • In Situ Pulmonary Artery Thrombosis
    • Pathophysiologic Consequences of Pulmonary Thromboses
    • Proposed Diagnostic Pathway for Pulmonary Thromboses in ARDS
    • Pulmonary Thromboses Treatment
    • Mechanical Ventilation Considerations With Pulmonary Thromboses
    • Outcomes
    • Summary
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

Keywords

  • acute respiratory distress syndrome
  • pediatrics
  • pulmonary embolism
  • thrombosis

Info For

  • Subscribers
  • Institutions
  • Advertisers

About Us

  • About Us
  • Editorial Board
  • Reprints/Permissions

AARC

  • Membership
  • Meetings
  • Clinical Practice Guidelines

More

  • Contact Us
  • RSS
American Association for Respiratory Care

Print ISSN: 0020-1324        Online ISSN: 1943-3654

© The Journal Respiratory Care Company

Powered by HighWire